Health & Nutrition by Michael R. Eades, M.D.

Just a quick post to let everyone know that I’m still alive and kicking. MD and I are closing in on the deadline for our book so I have been consumed in a frenzy of writing. Writing the last parts of a book are like losing the last five pounds - the most difficult part of the whole process. All the stuff you don’t want to dig in and write you keep putting off until you’re at the end of the project, and then there it is, still there and staring you in the face.

MD is much more industrious on a daily basis than I. She plugs along writing a little every day whereas I jump in and write in large chunks. Since she has plugged along for a long time and gotten her sections written, she is living large right now. I, on the other hand, am binge writing for all I’m worth.

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MD and I just got back from the Nutrition & Metabolism meeting in Phoenix. I’ve been dilatory in posting and in putting up comments because the meeting and the pre- and post-meeting socializing (most of which was discussion of one another’s work and the status of the low-carb diet in academia) took up all of my non-sleeping time. And all the pre- and post-meeting socializing included both film and podcast interviews.

The Nutrition & Metabolism meeting is held in conjunction with the annual meeting of the American Society for Bariatric Physicians (ASBP). We skipped the ASBP meeting because we couldn’t take the time away from the book project we’re working on. As a result we missed a terrific presentation by Robert Wolfe, formerly of the University of Texas Medical Branch in Galveston, now at my alma mater, the University of Arkansas. Dr. Wolfe has done much of the work on protein metabolism and has shown in a number of papers that good things happen when protein is substituted for carbohydrate in the diet. When MD and I got there, Dr. Wolfe was in the hall trying to escape from a barrage of questioners. I listened in and learned, among other things, that his work with glucogenogenesis has shown that the newly minted glucose (made from protein) goes first into glycogen and from there into the circulation. I always thought it went directly into the blood stream from the liver, but work with carbon 13 tracing shows that it goes into glycogen first.

Before I had to get suited up for the first interview, Richard Feinman and I were able to slip off and have a cup of coffee.

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While reading a scientific paper on the benefits of a carnivorous diet I noticed a paper in the list of references at the end that I had never seen cited. I tracked the paper down, read it, and learned that vegetarians have significantly higher rates of advanced glycation end products (AGE) than do omnivores.

Before we get into the study, let’s take a moment and discuss AGEs so we’ll all be on the same page. When proteins are incubated with sugars, over time the sugar attaches irreversibly with the protein in a process called glycation. (There are many names for the reaction: the Maillard reaction, Schiff’s base formation, the Amadori reaction, etc. with minor differences between these different processes, but debating the differences is pointless for our purposes.) If the protein performs a specific function in the body due to its unique structural conformation, and it finds itself with a sugar attached to it that it can’t get rid of, then this protein suddenly doesn’t function so well and becomes a junk protein that the body has to dispose of.

Since most of the structures in our bodies are made of protein, and since all of these proteins are bathed in blood that contains glucose, the normal course of events is for a portion of these proteins to undergo glycation. And the longer the proteins are in contact with the sugar, the more glycated proteins will be formed. All this goes on continuously in our bodies so as we age we accumulate more and more of these substances, thus the clever name AGEs.

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Olmsted County, MN

A recent paper in the Archives of Internal Medicine should give pause to those dispensing statins like candy. According to some fairly persuasive autopsy data, it appears that the rate of heart disease may be back on the rise after being in a slow decline over the past 40 years.

In Olmsted County, Minnesota, home of the Mayo Clinic, autopsies are much more common than in other parts of the country. So much so that the autopsy records of this county are often used in scientific inquiry as a surrogate for the country as a whole. Autopsies used to be more common nationwide but had fallen in 2003 to only 8.3 percent of deaths. Autopsies are conducted in Olmsted County at rates an order of magnitude greater than they are throughout the rest of the country.

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